Application form for beneficiaries

Grant Scheme for Childcare Facilities

The Regeneration of Childcare in Malta

Department for Social Welfare Standards

Ministry for the Family and Social Solidarity

September 2013

Cohesion Policy 2007 – 2013

Operational Programme I

Investing in Competitiveness for a Better Quality of Life

/ Operational Programme I – Cohesion Policy 2007-2013
Investing in Competitiveness for a Better Quality of Life
European Regional Development Fund (ERDF)
Maximum Co-financing rate: 85%EU Funds; 15%National Funds
Investing in your future /
PREAMBLE

Prior to completing this application, please refer to the Guidance Notes which are being issued by the Department for Social Welfare Standards, acting as the Intermediate Body (IB) for the purposes of this Aid Scheme. Reference to these Guidance Notes is essential to ensure the correct submission of the application.

Confidentiality will be maintained throughout the administration of this Aid Scheme, including the submission of this completed application form and all supporting documentation. The entities that will have access to information pertaining to the beneficiaries are the Department for Social Welfare Standards (as Intermediate Body), the Managing Authority within the Ministry for European Affairs and Implementation of the Electoral Manifesto, other stakeholders and official auditors of the scheme. However should a grant be offered and accepted, the list of beneficiaries and the amount granted will be made public (Regulation 1828/2006, Article 7 (2).

Application forms must be complete, and should be typed. All pages of the project application form must bear initials in blue ink. Furthermore, applications must be submitted by hand to the Administration Office of the Department Social Welfare Standards by not later than noon of Thursday 17th October, 2013. Applications must be accompanied by all supporting documentation. Where necessary please use additional sheets. The Intermediary Body shall acknowledge all applications in writing.

All data provided is processed in accordance with the Data Protection Act.

List of Sections

1. The Applicant

2. Information on the operation of the organisation

3. Project Proposal

4. Pending Issues

5. Financial details

6. Publicity

7. Bank Details

8. Further documentation

Department for Social Welfare Standards

Intermediate Body

1. The Applicant

Details of Organisation

Name of Organisation
Main Activity
Business Address
Telephone / Fax
Email
Type of Organisation / Enterprise Category / Headcount / Turnover or Balance Sheet Total
Micro
Small
Medium
Large / ‹ 10
‹50
‹250
›250 / ≤ €2 million or ≤ €2 million
≤ €10 million or ≤ €10 million
≤ €50 million or ≤ €43 million
≥ €50 million or ≥ €43 million

Details of Child Care Facility/Start-ups

Name of Facility
Address of Facility
Status of Facility / Upgrading of Existing Facility
Relocation of Premises
Start-up of New Premises
Telephone / Fax
Email

Details of Responsible Person of the Child Care Facility

Name
Position within Organisation
Title / Identity Card Number
Home Address
Telephone / Mobile
Email
Are you the owner of the child care facility? / Yes
No
Are you the person managing the child care facility?
(If no please give details of person managing the facility) / Yes
No

Details of Person Managing the Child Care Facility

Name
Title / Identity Card Number
Home Address
Telephone / Mobile
Email

2. Information on the operation of the organisation

2.1 Please tick correct profile of organisation:
Self-employed
Sole Trader
Co-operative
Registered company
Partnership
Voluntary Organisation
(registered with competent relevant authorities)
2.2 Registration of organisation with competent authorities according to the profile selected above. (Please provide necessary details and registration numbers where applicable)
2.3Provisional/Temporary Registration with Department for Social Welfare Standards
Yes / please give date of temporary /provisional registration / ___/___/___
2.4 Details about ownership and management details. (Where applicable, please include details of partners, board members, executive management staff and other details you deem necessary)
Those who have not yet set up their business, please describe organisational and business experience, or of persons managing the project
2.5.1Existing staff complement within the Childcare Facility
Total number of staff / Full-time staff / Part-time staff/Casual Workers
Designation of staff (pleaseattachan organisational chart)
2.5.2 Proposed staff complement within the Childcare Facility
Total number of staff / Full-time staff / Part-time staff/Casual Workers
Designation of staff (please attach an organisational chart)
2.6 Scope and function of the organization and the parent organisation (if applicable)
2.6.1 Services provided by Child Care Facility. (Please indicate present and proposed operating hours and the age range catered for. Also indicate if you intend to provide evening, night, after school and/or summer school services and provide detail of how each service will operate.)

3. ProjectProposal

3.1 a) Scope and detailed description of project proposal
3.1 b) Mention any innovative practice/s that address the developmental needs of the children using the services of childcare
3.1 c) Degree of networking
3.2 Project timeframe (in months)
Proposed start Date:______/ Proposed completion date:______
3.3 Projected outputs
Please state how the Scheme can help you improve your childcare service.
3.4 Indicators for measuring progress and outputs:
The applicant should provide information on the possible results acquired and the impact of the project in the following areas, if and where applicable:
Child Care Places:
  1. Number of children currently attending childcare facility at the date of submission of application:
  1. Estimated increase of number of children attending childcare facility through the scheme (Applicant needs to state how this is being calculated:
  1. Projected attendance figures of children attending new childcare facility (for relocated premises andstart-ups):
New Employment Opportunities:
a. Estimated number and type of new staff recruited in childcare facility, whether they are part-time, full-time or otherwise. (please also indicate, if applicable, the number of employees who have moved from part-time employment to full-time employment):
b. Extension of operational hours and/or opening times of the facility from the current service:
c. In the case of enterprises planning to offer child care services to their employees, give the estimated number of employees who would avail themselves of this service and the impact that this service would have on their intention to remain in employment or to enter/re-enter the workforce:
3.5 Describe how your project is likely to attract female employees into the workforce:
3.6 Show how the project fits within the objectives of the Operational Programme I, Priority Axis 6 (Urban Regeneration and Improving the Quality of Life) and Focus Area of Intervention (Education, Social and Health-Related Infrastructure)[1]
3.7 MEPA Permit
Does the project require a MEPA permit?
Yes No
If yes, give MEPA Permit number and details of application:
3.8 Impact on environment and Environmental considerations:
3.8.1 Do you intend to make use of alternative energy sources in your project?
If yes, please specify the sources you intend to use and how you intend
to implement them? / Yes / No
Specify sources below:
3.8.2Do you intend to adopt environmentally sensitive technologies
operating systems and processes? These can be energy saving
measures, solar heating, regeneration of existing property and
reduction of carbon emissions.
If yes, please specify the systems and/or processes you intend to
use and how you intend to implement them.
Specify systems and processes below:

4. Pending Issues

Does the organisation have any pending legal, administrative or operational issues with any of the following public sector entities?

- Ministry of Education and Employment

- Department for Social Welfare Standards (DSWS);

- Housing Authority;

- Social Security Division (DSS);

- National Commission Persons with Disability (KNPD);

- Malta Environmental and Planning Authority (MEPA);

- VAT Department;

- Malta Financial Services Authority (MFSA)

- Or any other public entity.

If yes, please give details:

5.Financial details

5.1 Project Budget
Eligible Items: Provide an exhaustive list of items to be co-funded by the Scheme. A budget breakdown should be provided. Use additional sheets if necessary. / Total Costs in Euro
Net amount / VAT / Total
Structural alterations to existing premises (for upgrades):
Procurement of necessary equipment and childcare furniture:
Physical renovation of new premises (for start ups):
Installation of hygiene facilities and infrastructural works:
Structural alterations to gain accessibility:
Embellishment of existing premises to meet childcare standards:
Setting up refurbishment/equipping new and existing childcare facilities:
Total VAT
Grand Total Cost in Euros
5.2 State Aid Regime
5.2.1 Does the organisation have any plans to apply for state aid within the next three years? If yes give details.

6.Publicity

Please indicate in the box below the type of publicity measures to be undertaken by the organisation to promote the project and to inform the public about this aid scheme
Year / 2014 / TOTAL
Quarter / 1st
(Jan –Mar 2014) / 2nd
(Apr– Jun 2014) / 3rd
(Jul–Sep 2014) / 4th
October 2014
Eligible costs
(exc. VAT) (€)
/ Disbursement
VAT of eligible costs
(€)
/ Disbursement
Total eligible costs
(inc. VAT) (€)
/ Disbursement

7.Schedules

7.1Disbursement Schedule

In the table below, please indicate the total amount of claims for reimbursement that you intend to forward in the quarters indicated below:

8.Bank Details

Applicants are requested to open a separate bank account for all the transactions that will be undertaken under the project.

Provide the bank account details where payments of eligible costs are to be effected. In the case of bridge financing through Bank, the submitted Account and IBAN Nos. cannot be changed without Bank’s written authorization.

Bank Name
Bank A/C Holder
Bank Branch
Bank Account Number
IBAN Number
BIC Code

9.Further documentation

Please attach the documentation listed below with your application and tick boxes accordingly:

  • Three-year business and financial plan,
  • Organisational Chart of organisation and facility,
  • Mepa Permit
  • Audited Accounts/Final Accounts of the last three (3) years,
  • Signed and Stamped statement from the bank of all the bank accounts,

● Declaration from Bank stating that applicant is able to co finance 15%/20%/30%

(as the case may be) of the project

  • List of employees from ETC, showing employees as at time of application(for those

already in operation),

  • Employment history sheet of the responsible person of the childcare centre, as

obtained from ETC,

  • Registration certificate/s with competent Authority,

Temporary or provisional registrationCertificate with DSWS for the registration ofChild Day Care Facility

  • Photocopy of Identity Card (from both sides) of Person Responsible,
  • Voluntary Organization certificate (if applicable),
  • Documentation required in respect of person managing the facility (as indicated in

Sec. 1), as follows:

  • Detailed Curriculum Vitae indicating relevant experience in the field,
  • Police ConductCertificate,
  • Authenticated copies of Certificates of relevant qualification,
  • Names and personal details of two character referees,
  • Employment history sheet, as obtained from ETC.
  • Annex – State Aid Declaration
  • Declaration from Beneficiary confirming that items being claimed for are not being

financedfrom any other EU funded Programme and National Funds.

  • Networking agreement/s

10.Declaration

The information requested in this form is being gathered for the purposes of determining whether the applicant is eligible to benefit from this Scheme. All information will be processed in accordance with the Data Protection Act, Cap 440 of the Laws of Malta and shall be treated in the strictest confidence.

You have the right to access, rectify, and, where applicable, the right to erase data concerning you. DSWS guarantees fair processing in respect of your personal information. DSWS will solely send you information related to the Department’s services.

I hereby understand that DSWS reserves the right to reject my application, if this is incomplete in submission.

I hereby authorise the DSWS to process the data contained in this form for the purpose stated above and declare that the information on this form and any other information given in support of this application are correct to the best of my knowledge.

Signed ______Date ______

Name (BLOCK CAPITALS) ______

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ANNEX 1

State Aid Declaration (De Minimis)

The Regeneration of Child Care in Malta

If the submitted application is approved, the project will benefit from de minimis State aid in line with the new Commission Regulation (EC) No. 1998/2006 of 15 December 2006 on the application of Articles 87 and 88 of the EC Treaty to de minimis aid.

Commission regulation (EC) No. 1998/2006 allows an undertaking to receive an aggregate maximum amount of de minimis aid of €200, 000 under all de minimis aid measures, over a period of three fiscal years. This aggregate maximum threshold applies in principle to all economic sectors with the exception of the road transport, agriculture and fisheries sectors for which different thresholds and criteria apply. For the purpose of this declaration the term ‘undertaking’ includes also all companies in a group (which fall under the direct or indirect ownership or control of the same ultimate parent company) and relevant partner and linked enterprises as defined in Annex 1 of Commission Regulation (EC) No. 800/2008. Moreover ’fiscal year’ means the fiscal year as used for tax purposes by the undertaking concerned.

This maximum threshold would include all State aid granted under this scheme and any other State aid measure granted under the de minimis rule. Any de minimis aid received in excess of the established threshold will have to be recovered, with interest, from the undertaking receiving the aid.

The following is an indicative list of the possible forms of State aid:

  • Grants from public bodies
  • Loans or loan guarantees at favorable rates
  • Tax benefits
  • Waiving or deferral of fees or interest normally due
  • Marketing and advertising assistance
  • Consultancy, training and other support provided either free or at a reduced rate
  • Aid for investment in environmental projects or research and development assistance
  • Purchase, rent or lease of immovable property at less than market rate.

Potentially any assistance from a public body may constitute State aid. Should you have any doubts whether any public assistance received is de minimis aid, you should contact the agency or department from which the assistance was received in order to ascertain this.

Declaration

I declare that a comprehensive amount of de minimis aid received to date over the last three fiscal years is:

Fiscal Year 2010 / Fiscal Year 2011 / Fiscal Year 2012 / TOTAL
Euro / Euro / Euro / Euro

A breakdown of the source, type and amount of de minimis aid received as well as that applied for from any state aid generator is presented overleaf.

______

Business Undertaking (Full Legal Name) VAT Registration Number

______

Name and Surname (BLOCK CAPITALS) Position in Establishment

______

Signature Date

Detailed information concerning applicable State aid under the

de minimis rule.

(Note: Information should include both State aid received as well as applications for de minimisState aid still pending approval by potential grantors)

Date
/

Source/Grantor

/ Type of State Aid /

Amount in Euro

Eg: 12/01/2009 / Central Government / Soft Loan Scheme / 10,000

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[1]Further information regarding the focus area of intervention can be obtained from pages 135 and 136 of the Operational Programme 1, that can be downloaded from